Abstract
Foreign body ingestion is an uncommon cause of gastric outlet obstruction in adults. Not all ingested objects pass the gastrointestinal tract spontaneously. In most cases, endoscopic removal is required. A surgical approach is required if endoscopic removal is unsuccessful or in the event of a complication. We present a case of a 45-year-old woman, previously diagnosed endoscopically with chronic duodenal ulcer with pyloric stenosis, who presented with copious effortless offensive non-bilious vomiting, and epigastric pain of three weeks’ duration. She was dehydrated with positive gastric succussion splash. Esophago-gastro-duodenoscopy showed an impacted neck-pendant occluding a stenosed pylorus which dislodged on attempts to extract it and was later excreted in the stool, with resolution of her symptoms.
Highlights
Foreign body ingestion is a common occurrence in children [1]
Foreign body ingestion is an uncommon cause of gastric outlet obstruction in adults
We present a case of a 45-year-old woman, previously diagnosed endoscopically with chronic duodenal ulcer with pyloric stenosis, who presented with copious effortless offensive non-bilious vomiting, and epigastric pain of three weeks’ duration
Summary
Foreign body ingestion is a common occurrence in children [1]. Foreign body ingestion is commonly seen in patients with psychiatric or intellectual impairment, and in alcoholics [1] [2]. It is important to note that most ingested foreign objects spontaneously pass through the gastrointestinal tract with minimal clinical or surgical intervention [1]-[6]. Endoscopic or surgical intervention is required in about 20% of cases [1] [2]. Intermittent gastric outlet obstruction is usually explained by duodenal ulcer with recurrent edema [1] [2] [3]. We present a case of a patient with acute gastric outlet obstruction due to an impacted neck pendant within a stenosed pylorus
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